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Educating and training of HCW on hand hygiene

Introduction

One of the major causes of mortality and morbidity among hospitalized workers is healthcare associated infections, particularly resulting from health cares workers (HCW) noncompliance with hand washing protocols. It has been identified that infections resulting from noncompliance with hand washing standards affect nearly two million people annually in the Unite States alone and are responsible for around 90,000 deaths each year (Alemagno et al, 2010). The infections results from transmission of health-care-associated pathogens during healthcare operations via contaminated hands of HCW. Research conducted in healthcare institutions has shown that compliance with the recommended hand hygiene procedures is below the set benchmark of 100%. In fact, Alemagno et al (2010) noted that adherence to hand hygiene guidelines in United States ranges between 30% and 60% and hardly exceed 50%.

Various reasons have contributed to this lack of 100% compliance with hand washing among HCW including lack of knowledge regarding the significance of hand hygiene in reducing the spread of infections to patients. It has been identified that some HCW lack adequate understanding of how hands become contaminated and the correct hand hygienic techniques (Souza, 2010). To overcome this barrier, it has become increasingly important for healthcare organizations to enhance educational and training strategies which will help to increase hand hygiene compliance. This can be achieved in various ways as explained in the following section.

Educating and training of HCW on hand hygiene

There are various education and training opportunities available for HCW, which can significantly help to promote compliance with hand washing protocols. One of these opportunities described by Alemagno et al (2010) is through online learning. Alemagno et al (2010) explains that the emergence and development of online learning opportunities over the last decade has raised new opportunities for providing education and training among HCW regarding compliance with hand hygiene standards. Alemagno et al (2010) conducted a study investigating the effectiveness of an online continuous education and training program in increasing knowledge among HCW of hygienic procedures and practices. The study also assessed the effectiveness of the program in promoting behavioral change among HCW and the extent to which such a program can promote adherence to hand hygiene guidelines. This study involved 256 HCW selected from two health care institutions in Ohio, United States.

All the participants were taken through three sessions of online education program. All the participants involved in this study recorded significant improvement in hand washing knowledge and reported improved adherence to hand washing guidelines. Precisely, 97% of the participants reported that this online education program was highly influential and thus, helped to improve clinical compliance behaviors. Generally, the results of this research indicate that online education program available for HCW can help to update their knowledge, thereby promote compliance with hand hygiene standards.

The results of the above study were consistent with suggestions made by researchers at the University of Geneva in Switzerland. They suggested that focusing on behavioral, normative and control beliefs can greatly help to improve enhance adherence of HCW to hand hygienic guidelines. In a study conducted by these researchers, they found that compliance with hand washing guidelines was highly associated with the belief that hand hygiene helps to prevent infections and adherence requires little effort (Waltman et al, 2011). The researchers associated lack of knowledge with noncompliance with hand washing guidelines. According to Alemagno et al (2010), these beliefs are often influenced through education and training programs.

Another education strategy which can help to increase compliance with hand hygiene guidelines is the inclusion of a work-based training program, especially for new employees. An observational study conducted in four hospitals in United States indicated that inclusion of work-based hand washing education programs and the availability of an effective sanitizer significantly helped to reduce infections resulting from antimicrobial- resistant bacteria (Holyoake, 2010). It was found that adherence of HCW to hand hygiene guidelines remained high in healthcare institutions where the program was included.

In addition to regular work-based teaching, HCW can learn more about hand hygiene through attending face-to-face education seminars discussing the importance and the correct procedures of hand washing. Various studies conducted in clinical organizations have showed incorporating regular learning programs in form of seminars highly increase adherence to hand hygienic standards. A study under this topic was carried out by Lam (2006) in one health institution in United States, which included this program for the first time. The researcher found after HCWs in the institution attended 10 seminars discussing matters related to hygiene, compliance increased from 40% to 59% before and after patient contact. For high risk procedures, hygienic compliance increased from 35% to 60% (Lam et al, 2006). Number of patient contacts in the institution decreased from 2.8 % to 1.8% per hour. As well, there was a remarkable improvement in various aspects of hand washing technique after the intervention. Importantly, health care-associated infection rate in the institution decreased from 11.3% to 6.2% per 1000 patient-days.

Display of reading materials in strategic positions can also help to improve adherence to hand washing guidelines (Alemagno et al, 2010). Materials such as posters placed on notice board can help to constantly remind HCW about the need for hand hygiene. Analysis done in several healthcare institutions in United States indicated that after frequent exposure to hand hygiene guidelines, approximately 75% of the HCW believed that it is possible to improve their hand hygiene practices and to meet the 100% benchmark (Alemagno et al, 2010). Around 75% of the workers involved in the study indicate that half of hospital infections occur as a result of poor hand hygienic practices.

Alemagno et al (2010) noted that HCW can also learn indirectly from their superiors in healthcare organizations. For this to occur, management personnel in these organizations need to completely adhere to clinical guidelines, hence act as role models to workers. An analysis done in United States indicated that HCW adherence to hand hygienic guidelines increased when superiors within healthcare organizations acted as role models for hand hygiene. These findings were consistent with another study involving 60 nursing students. It was found that found that the greatest predictors of compliance with hand hygiene guidelines were the tutor’s positive example of hygiene and positive attitude towards compliance (Alemagno et al, 2010). This view is also supported by the findings of a study that involved new versus old healthcare organizations in United States. It was found that though new healthcare organizations had more sinks, there was lower compliance with usage. The lower compliance with hand hygiene in the new healthcare organizations was linked to the behavious or senior staff. The senior staff in the new organizations cleaned their hands less frequently compared to senior staff in old organizations.

Summary

In conclusion, healthcare associated infections resulting from poor

References

Alemagno, S., Guten, S., Warthman, S., Young, E., & Mackay, D. (2010). Online Learning to Improve Hand Hygiene Knowledge and Compliance Among HealthCare Workers. Journal Of Continuing Education In Nursing, 41(10), 463-471. doi:10.3928/00220124-20100610-06

Holyoake, D. (2010). The Awkward Feeling campaign: confronting poor hand hygiene to improve hand washing. Nursing Times, 106(35), 18-20.

Lam, B. C. C., (2006). Hand Hygiene Practices in a Neonatal Intensive Care Unit: A Multimodal Intervention and Impact on Nosocomial Infection. Rediatrics 114(5), 565-571

Souza, M. (2010). Adhesion to the practice of hand hygiene by professionals in the health area in a university hospital [sic] [Portuguese]. Revista Eletrônica De Enfermagem, 12(2), 266-271.

Waltman, P. A., Schenk, L. K., Martin, T. M., & Walker, J. (2011). Effects of Student Participation in Hand Hygiene Monitoring on Knowledge and Perception of Infection Control Practices. Journal Of Nursing Education, 50(4), 216-221. doi:10.3928/01484834-20110228-06

Final Result of the Debate, The American elections

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Professor

Final Result of the Debate, The American electionsIntroduction

The American elections are known as a two-horse race between the Republican and the Democrats. In 2012 election, the flag bearers of the aforementioned parties were Mitt Romney, a republican presidential nominee while president obama led the Democrat.

Romney comes from a prominent political family, given his father, George, was 43rd governor of Michigan and an automotive executive. Among the higher learning institution he went through are the Stanford University, Brigham Young University and eventually graduated from Harvard University with an M.B.A/J.D. He headed a spin-off equity firm at Bain & Company. In 1994, he contested for Massachusetts senate seat unsuccessful; however, he became the governor for Massachusetts from 2003-2007. He also made an unsuccessful bid for republican presidential nomination in 2008.

On Obama side, he made history in 2008 as the first black president to have ever headed a powerful nation in the planet, and the 44th president of U.S. His father was a Kenyan and his mother was an American. Obama studied at Punahou Academy where he did well in basketball and graduated with academic honors in 1979. Other tertiary schools he went through include Occidental College in Los Angeles, Colombia University where he got a degree in political science. Before pursuing politics; he served as civil rights lawyer, a writer and teacher. He was first elected as the senator for Illinois in 1996-2004, and in 2012, he got re-elected against his challenger Romney.

Thesis

Obama narrowly clinched the presidential ticket against his rival, Mitt Romney, to serve for another four year term.

The candidates spent over $2 billion in their campaigns; hence, they were to spent more time in fundraisers.

Despite exchanging hash words, both competitors promised to work together in healing the US economy.

Both candidates held conflicting views and policies, and even their campaign trains were totally dissimilar. Romney was disapproved by election results as he was confident of winning.

Campaign Budget

The American constitution requires presidential candidates to register their campaign spending reports with the Federal Election Commission on a monthly basis. Here, is how the presidential hopefuls massed up the cash chase.

The two presidential candidates spent a combined $30.33 per second in their election circle, as a spree of campaign spending flooded voters with banners, TV Ads, and rallies. By the mid October 2012, both parties had spent approximately $1.7 billion. This means that more than $2.6 million were spent on a daily basis and more than $79 million per month. Hence, it was not a surprise to observe them spent much of their time in fundraisers (Javers & Joseph, n.p).

Since January 2011 to November 2012, the Obama campaign had spent more than $553.2 million, plus another $262.2 million spent by the Democratic National Committee. In addition to this, the top “Super PACs” cashed in additional $58 million, bringing the totals to over $874.6 million burned before election (Javers & Joseph, n.p).

On the other hand, Romney campaign spent $360.4 million within the same period, in addition to $284.2, and $200.1 million contributed by the Republican National Committee and the top three Romney Super PACs respectively. This brought the figures to over $844.6 million in total. The Romey team had approximately $30 million less than the Obama team.

The force behind president Obama’s success spent about $5.98 per registered voter. The result was calculated by dividing the total amount by the total registered voters in the last campaign, which was over 146.3 million. Romney’s team, on the other hand, spent approximately $5.77 per voter. Hence, if combined, that is around $11.75 per voter (Javers & Joseph, n.p).

Some top contributors for Obama campaign team include University of California, Microsoft Corp, Google Inc, Us Government, and Harvard University. On Romney side, we have Bank of America, Goldman Sachs, Morgan Stanley, JPMorgan Chase & Co, and Credit Suisse Group.

The Campaign Structures

Obama campaign team used an online organizing tool, aimed to incite the volunteer enthusiasm that saw him won the white house contest four years ago. The program, called Dashboard was built off technology, and to imitate a campaign field office. It facilitated volunteers to organize events, perform phone banking and even chat with campaign leaders from their Smartphones or laptops. This was latest mechanism of democrats, betting to clinch victory after the internet was acknowledged with assisting accelerate Obama in 2008. The Dashboard outlook borrowed some feature from Facebook’s blue-and-white layout. On the left, volunteers would view recent activities such as profile updates from people, and from the home page, users would see phone numbers of those intending-to-be voters (Allen, n.p). The staff also used the program to systemize and track volunteers’ advancement. There were many movements such as Women for Obama, Obama for America; therefore, the Dashboard aimed at feeding supporters with information concerning local efforts and let volunteers view how their efforts were compared with those of others.

On Romney side, the campaign team embarked on television advertising, a known stronger way to entice wavering voters. They also developed another method on Facebook called GOP Social Victory Center. It was meant to systematize supporters in the virtual world. In a nutshell, Romney’s campaign team focused less on other technology spending other than advertising companies and telemarketers (Allen, n.p). Top executives in the Romney campaign only considered their own base by inviting their own firms and those of acquaintances to provide vital services. The Romney campaign totally left majority of its technology fate to willing outsiders to fix them.

Their Actions During and After Election result

During the campaigns, the two presidential candidates exchanged bitter words. Interestingly, both candidates were armed with figures, numbers, percentage and statistics, to strengthen their arguments and attacks. Romney accused the president’s inability to confront a sluggish economy (unemployment) while the president retaliated by citing over two years of positive employment growth. Issues that dominated their speech include unemployment rate, Medicare, taxation system, cutting deficit, foreign policies, war on terror particularly Afghanistan, among others. This made Romney amass more confidence on winning the ticket, more so after the first debate. His team believed that republican will sweep their man to victory coming 6th November election. Also their speeches were in a way to distinguish them from one another, particularly when they visited swing states such as Ohio and Lowa (“Mack”McLarty, p1).

After winning, president Obama called for unity and set out confident vision of America’s future. He even broke in to tears as he gave out a speech. The Obama campaign team had projected victory few days, but nervously waited for the election results. Even as the results seemed to favor the president, they kept their focus on Ohio. Obama also held a traditional Election Day basketball game in the afternoon (“Mack”McLarty, p1).

Obama promised the best in his final term as the U.S. president, and he even claimed that the fierce encounter with Romney made him a better president. He vowed to return to the white house more focused and inspired than ever. He promised to stabilize the economy, and end the decades of war and campaign in his four year term. He also paid tributes to his opponent and invited him to partner with him in building the U.S. economy, a proposal that Romney had earlier suggest in his concession speech (“Mack”McLarty, p1).

Equally, Romney held his presidential concession speech in Boston, an hour before the president gave out his speech. He praised efforts made by his running mate Ryan, His wife Ann, and his children together with his supporters. He also congratulated president Obama on his re-election, and he encouraged the Americans to bipartisan co-operation (“Mack”McLarty, p1).

Reason for contesting for Presidency

Other than to defend his seat, Obama vied for re-election to finalize implementation of the projects he had started and promises he made to the Americans four years ago. His agenda for 2013-2017 was prioritize education and training, promote American-made energy, create on American processing boom, cut deficits where necessary by asking the wealthier to pay more tax. He also promised to end war, particularly on Afghanistan in order avail more finance to the nation-build America (Aljazeera, n.p).

Romney on his side, he was after reforms that included chains of reforms to budgetary, energy, tax, trade, labor and energy policies that would drive job creation. He also wanted to shun ObamaCare, implement tort reform and create a fence along the border with Mexico, armed with security guards. He also wanted to ban same-sex marriages, and cut non-defense discretionary spending by about 5%. On foreign policies, he expressed his desire to reverse defense cuts, and increase funding to the missile and Navy defense programs (Aljazeera, n.p). He also promised to authorize the department of energy to review domestic energy production aptitudes.

Impact of the Outcome on the US Economy

At last Obama won; however, the bitter campaign has since divided the Americans. Therefore, the president has a fragile command and a quick domestic to-do list. Consequently, there is latest rising world order from the euro zone crisis, the Arab spring and emerging US leadership, and Asia. The president need to come-up with effective fiscal and monetary policies to get more jobs to the Americans, given that over 3.6 million Americans have surviving without jobs (“Mack”McLarty, p1).

Conclusion

The campaign spending were historic and the most expensive ever since in the US history with Obama leading by over $30 million against Romney. There campaign structures differed significantly, and Obama’s campaign structure being favored as most efficiently organized than Romney. Romney only focused on television Ads while Obama balanced his Ads from Dashboards to television. Throughout the campaign, Romney mercilessly accused Obama of failing to heal the US economy, thereby throwing Obama on a defensive side. The candidates’ policies were conflicting, and in their manifesto they expressed different interests for running for the presidency. In defacing Obama, Romney gained more hope of clinching the presidency, sending Obama campaign team in fear of losing the election. Lastly, Obama earned f a second term in office, and the outcome for his re-election are yet to be seen.

Where Obama and Romney Stand on the Issues. Aljazeera 6 Nov. 2012: n. pag. <http://www.aljazeera.com/indepth/interactive/2012/09/20129308542614575.html>. 25 Nov. 2012.

Eamon Javers & Jessi Joseph. “Campaigns spent $30.33 per second for your vote”. Globalpost 5 Nov. 2012: n.p. http://www.globalpost.com/dispatch/news/business/121105/election-record-spending .25 Nov. 2012.

F.E, Allen. Romney, the Great Manager? Not Nearly as Good as Obama, the Election Proved. Forbes 10 Nov. 2012: n.p < http://www.forbes.com/sites/frederickallen/2012/11/10/romney-the-great-manager-not-nearly-as-good-as-obama-the-election-proved/>. 25 Nov. 2012.

F.T “Mack”McLarty. A bipartisan Solution to the “Fiscal Cliff”. Washington Post 10 Nov. 2012: p1 <http://www.washingtonpost.com/opinions/fiscal-cliff-has-bipartisan-solution/2012/11/09/6e46845e-2aa0-11e2-96b6-8e6a7524553f_story.html> 25 Nov. 2012.

Improving Levels of Physical Fitness Through FIT (Frequency Intensity and Time)

Improving Levels of Physical Fitness Through FIT (Frequency Intensity and Time)

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During the start of exercises, people find it to be extremely difficult. Most times, the excuse, which people give, include not having enough time, as well as schedules that are hectic. Information regarding to regiments of fitness are either false or true. This is in turn reflected on how a person’s body is. Through using the principle of F.I.T one can get the right information regarding to exercises (Van Dusen, 2008).

Frequency means that the number of times exercises are done. Repairing and rebuilding occurs when a body is subjected to exercises. One should strive to ensure that a balance is found while exercising for purposes of frequency determination. It will be thus easy for healing and adaptation of the body (Hahn & Eades, 2002). In every workout, the energy and effort used is referred to as intensity. The two must be balanced well; in order to make sure that the exercises will provide excellent results. Burn out, injury and overtraining may occur if one’s body is overloaded during training. Time is also an essential aspect, which ensures that one trains sufficiently depending on the type and intensity of the training. Other authors believe that in FIT training, type of training is also essential as it can be either cardiovascular of resistance training. Some people prefer doing both exercises in order to obtain excellent results.

The fitness regimes, which I make use of, is the one on cardiovascular training. F.I.T.T is advocated for by the American College of Sport Science because of its many benefits. My fitness regimes necessitates that I train on a weekly basis and this is four times. In accordance to the model they recommend three to five times’ frequency, weekly. The intensity recommended is measured in terms of heart rate at a maximum level. The latter is at a percentage of sixty to eighty five (Powers, Scott. & Howley, 2003). The training should be conducted for a period of about twenty to sixty minutes. The fitness routine, which I use, measures up to that of the F.I.T model. The model has instructions for different populations, who might want to engage in exercises. Some of the populations include; Sick people, those who want to add or lose weight, those who want to maintain their weight, athletes, and body builders. The population is then further put into groups depending on their ages (Sports fitness advisor, 2011).

Athletes that undergo training of a cardiovascular nature often have a higher frequency as compared to other populations. This is because they have more intensity and energy as compared to other people. On the other hand, training of a resistance nature is a program tailored according to an individual (Smith & Coombes & Geraghty, 2003). It mostly focuses on some parts of the body and an example of a population which follows this is body builders. This training should not be done more than four times in a week. The latter depends on the body parts being worked upon. In order to come up with effective programs for fitness, the F.I.T model should be used by health educators. They will use it to come up with appropriate timings, intensity, frequency and types, which will benefit their clients. This is because they are meant to ensure that populations who exercise for health reasons do not end up becoming worse off as compared to before. In conclusion, the model of F.I.T.T should be used by people who want to engage in beneficial exercises (Donatelle, 2005).

References

Delavier, Frederic (2001). Strength Training Anatomy. New York: Human Kinetics Publishers.

Donatelle, Rebecca. (2005). Health: The Basics. 6th ed. San Francisco: Pearson Education, Inc.

Hahn, Fredrick. & Eades, Mary. & Eades, Michael. (2002).The Slow Burn Fitness Revolution: The Slow Motion Exercise That Will Change Your Body in 30 Minutes a Week. New York:

Crown Archetype.

Powers, Scott. & Howley, Edward. (2003), Exercise Physiology. New York: McGraw Hill.

Schoenfeld, Brad. (2002). Sculpting Her Body Perfect. New York: Human Kinetics Publishers

Smith, T. & Coombes, J. & Geraghty, D. (2003). “Optimizing high-intensity treadmill training using the running speed at maximal O (2) uptake and the time for which this can be maintained”. Eur. J. Appl. Physiol. 89, 3: 337–43.

Sports fitness advisor. (2011). The FITT Principle of Training. Retrieved from HYPERLINK “http://www.sport-fitness-advisor.com/fitt-principle.html” http://www.sport-fitness-advisor.com/fitt-principle.html.

Van Dusen, Allison. (2008). HYPERLINK “http://www.forbes.com/2008/10/20/exercise-workout-shorter-forbeslife-cx_avd_1020health.html” “Ten ways to get more from your workout”. Forbes. Retrieved from HYPERLINK “http://www.forbes.com/2008/10/20/exercise-workout-shorter-forbeslife-cx_avd_1020health.html” http://www.forbes.com/2008/10/20/exercise-workout-shorter-forbeslife-cx_avd_1020health.html.